Douglas George Petersen in Edina - Periodontics
Douglas George Petersen - NPI 1134208630
Douglas George Petersen is a Periodontics in Edina, Minnesota. Douglas George Petersen practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Douglas George Petersen is 1134208630. The last update date is 2007-07-08.
Douglas George Petersen's current location address is 6545 France Ave S, Edina, Minnesota. You can contact this provider via phone number 9529262763. The mailing address for Douglas George Petersen is 6545 France Ave S, Edina, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Douglas George Petersen |
|---|---|
| Address | 6545 France Ave S, Edina, Minnesota |
| Phone Number | 9529262763 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1134208630 |
|---|---|
| Provider Enumeration Date | 2006-11-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 6545 France Ave S |
|---|---|
| City | Edina |
| State | Minnesota (MN) |
| Post Code | 554352131 |
| Phone Number | 9529262763 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | D10423 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Post Comment/ Review Below
What is the unique identifier code issued to Douglas George Petersen by the Centers for Medicare & Medicaid Services (CMS)?
The Douglas George Petersen has been assigned the NPI (National Provider Identifier) 1134208630. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Douglas George Petersen's physical address?
The Douglas George Petersen is physically located at 6545 France Ave S, in the city of Edina, MN, with the postal code 554352131.
What is the Douglas George Petersen's area of specialization and corresponding taxonomy classification?
The Douglas George Petersen's specialty field is Periodontics, and it falls under the taxonomy code 1223P0300X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1134208630 to Douglas George Petersen?
The Centers for Medicare & Medicaid Services assigned the 1134208630 to Douglas George Petersen on 2006-11-03.
As of what date were the details pertaining to Douglas George Petersen last refreshed?
The information related to the Douglas George Petersen, including its address, specialty, and other relevant details, was last updated on 2007-07-08.